ALT "Mechanisms of change in cognitive functional therapy: A longitudinal mediation analysis of the RESTORE clinical trial for disabling chronic low back pain" (Behaviour Research and Therapy, https://doi.org/10.1016/j.brat.2025.104853). 62% of CFT's large effect on pain intensity at 1 year is caused by earlier improvements in self-efficacy, catastrophising and fear. This is the first causal evidence of CFT mechanisms within a clinical trial. To explain the rest of CFT's large effects on pain and disability we need to explore other likely mechanisms, like improvements in movement behaviours.